David Shoup

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2000175328 Issued in MO

Practice address

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Phone

(573) 596-9602

NPI assigned

Jan 14, 2007

Last updated

Mar 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: dshoup815@directb.mercy.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Omc Breast Care

  dba Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1255542700
  NPD (past)
• Omc Fee for Service

  dba Ozarks Medical Center

  • Family Medicine Physician
  • West Plains, MO
  • NPI 1487865945
  NPD (past)
• Omc Youth TCM

  dba Ozarks Medical Center

  • Community/Behavioral Health Agency
  • West Plains, MO
  • NPI 1518169481
  NPD (past)
• Ozarks Medical Center

  dba OMC Orthopaedic Clinic- Hand Center

  • Orthopaedic Hand Surgery Physician
  • West Plains, MO
  • NPI 1033456694
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare at Home, Community Care

  • In Home Supportive Care Agency
  • West Plains, MO
  • NPI 1063493237
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare Pediatrics

  • Rural Health Clinic/Center
  • West Plains, MO
  • NPI 1154838209
  NPD (past)
• Ozarks Medical Center

  • Psychiatric Hospital Unit
  • West Plains, MO
  • NPI 1235929027
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare Family Care

  • Family Medicine Physician
  • West Plains, MO
  • NPI 1285801696
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare Mountain View

  • Rural Health Clinic/Center
  • Mt View, MO
  • NPI 1295815017
  NPD (past)
• Ozarks Medical Center

  • Skilled Nursing Facility
  • West Plains, MO
  • NPI 1326119769
  NPD (past)
• Ozarks Medical Center

  dba Ozark County Ambulance

  • Land Ambulance
  • Gainesville, MO
  • NPI 1326213406
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare Mountain Grove

  • Rural Health Clinic/Center
  • Mountain Grove, MO
  • NPI 1376679423
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1386795722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUP",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2000175328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Sheahan
• Rebecca Shepard
• Christina Ann Shepherd
• Alma Delia Short
• Mark S Short, PA-C
• William Brian Shurtleff, FNP-C
• Lydia Sickbert, MD
• Isatu Kamara Sidibe
• Victoria Dawn Simms
• Jill Stephanie Simono

• Physician Assistant in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.